New York State Department of Health, Wadsworth Center
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737 Park Avenue Ambulatory Center LLC
PFI: E953 Secondary Site ID: 0000 Certification Type: WAIVER Director: Marc Zimbler, M.D. Phone: (212) 433-0737 Fax: Address: 737 Park Ave - Suite 1B, New York, NY 10021 County: New York Country: United States Single or Primary Contact: Shana Ackerman Contact Phone: (425) 503-1607 CLIA #: 33D2251653
PFI: E957 Secondary Site ID: 0000 Certification Type: WAIVER Director: Eugene M Raber, M.D. Phone: (212) 479-1200 Fax: (212) 572-0901 Address: 139 E 56th St, New York, NY 10022 County: New York Country: United States Single or Primary Contact: Christine Broughton Contact Phone: (212) 479-1200 CLIA #: 33D2252358
PFI: E959 Secondary Site ID: 0000 Certification Type: WAIVER Director: Sangeet Khanna, M.D. Phone: (516) 859-4516 Fax: Address: 100 Park Ave, New York, NY 10017 County: New York Country: United States Single or Primary Contact: Contact Phone: CLIA #: 33D2255207
PFI: E962 Secondary Site ID: 0000 Certification Type: WAIVER Director: Augustus Valmond, M.D. Phone: (917) 675-6588 Fax: (718) 702-1201 Address: 235 W 135th St, New York, NY 10030-2861 County: New York Country: United States Single or Primary Contact: Jolinda Malotaj Contact Phone: (347) 299-4011 CLIA #: 33D2194530
PFI: E969 Secondary Site ID: 0000 Certification Type: WAIVER Director: Mark Ilyagu, M.D. Phone: (718) 790-8718 Fax: Address: 1706 Ave M - Suite 2, Brooklyn, NY 11230 County: Kings Country: United States Single or Primary Contact: Contact Phone: CLIA #: 33D2252364
PFI: E971 Secondary Site ID: 0000 Certification Type: PPMP Director: Jose E Baez, M.D. Phone: (845) 883-6883 Fax: (845) 883-6254 Address: 514 State Rte 299, Highland, NY 12528 County: Ulster Country: United States Single or Primary Contact: Susan Dalonzo Contact Phone: (203) 702-0888 CLIA #: 33D2253723
PFI: E973 Secondary Site ID: 0000 Certification Type: WAIVER Director: Michelle D Piacente, P.A. Phone: (917) 677-5750 Fax: (201) 630-8441 Address: 224 W 35th St - Suite 905, New York, NY 10001 County: New York Country: United States Single or Primary Contact: Anthony Walho Contact Phone: (201) 783-3126 CLIA #: 33D2250578
PFI: E980 Secondary Site ID: 0000 Certification Type: WAIVER Director: Charles J Hinz, D.O. Phone: (718) 975-8555 Fax: (718) 975-8556 Address: 380 Ralph Ave, Brooklyn, NY 11233 County: Kings Country: United States Single or Primary Contact: David Faour Contact Phone: (718) 975-8555 CLIA #: 33D2214331